Meningitis-retention syndrome (MRS) a combination of acute aseptic meningitis and urinary retention (detrusor underactivity) is a newly-recognized inflammatory neurological condition,^[1][2][3][4] therefore the prevalence remains still unknown.

MRS occurs in any age, clinically MRS is defined as a combination of a) aseptic meningitis (increased reflexes without leg weakness might be seen; abnormal cerebrospinal fluid alone can also accompany^[5]) and b) acute urinary retention. Aseptic meningitis is a common condition, which is caused by many viruses but also from autoimmune etiologies. MRS occurs in 8% of aseptic meningitis cases. Average latencies from the onset of meningeal irritation to urinary symptoms were 0-8 days. However, in some cases, urinary retention precedes fever and headache. The duration of urinary retention in MRS was mostly 7-14 days, lasting up to 10 weeks. Mild acute disseminated encephalomyelitis (ADEM) is considered an underlying mechanism of MRS, because some patients show elevated myelin basic protein in the CSF and a reversible splenial lesion on brain magnetic resonance imaging .^[6]

As it is observed in ADEM, antecedent/ comorbid infections or conditions with MRS include Epstein–Barr virus, herpes simplex virus, varicella-zoster virus, West Nile virus, listeria, etc. In addition to these, elevated CSF adenosine deaminase (ADA) levels or decreased CSF/serum glucose ratio may be predictive factors for MRS development.^[1]

Urodynamic testing including cystometry show that all patients examined had underactive bladder/detrusor underactivity when on retention. Repeated urodynamics showed that underactive detrusor changed to overactive after a 4-month period, suggesting an upper motor neuron bladder dysfunction (possible spinal shock). MRS should be differentiated from genital herpes (herpes simplex virus,^[7][8] varicella-zoster virus^[9][10]) and so-called Elsberg syndrome.^[11] Clinical/pathological features of Elsberg syndrome were: rare CSF abnormalities; no clinical meningitis; a subacute/chronic course; presentation with typical cauda equina motor-sensory-autonomic syndrome; Wallerian degeneration of the spinal afferent tracts; and mild upper motor neuron signs. All these are different from those of MRS.^{[12][13][14][15]}

It is believed that MRS is a self-limited disease, the duration of urinary retention in MRS was mostly 7-14 days, lasting up to 10 weeks. While urinary retention in MRS ameliorates in most cases, care must be taken to prevent overdistension bladder injury, by performing clean-intermittent self-catheterization. It is not known whether steroid pulse therapy might shorten the period of urinary retention, because of MRS's self-remitting feature.^[16][17]

This disease was described first by Sakakibara R et al. in 2005.^[1]

• Neurogenic bladder dysfunction
• Aseptic meningitis
• Autonomic nervous system
• Autonomic failure,dysautonomia
• Multiple sclerosis
• Spinal cord
• Nerve root
• Urinary retention
• Fowler's syndrome
• International Continence Society